A lifetime ago, I taught fitness classes at the YMCA. During my tenure there, I cannot count the number of people who used to ask me for weight loss advice and/or personal training secrets. My answer was always the same, “Eat less and exercise more. If you burn more calories than you take in, you’ll lose weight. If you don’t, you won’t.” Out of the innumerable askers, a very numerable minority took me up on it: one. Only one person out of the throng responded to the harsh reality that 1500 calories = 1 pound, no matter how you slice it or dress it up. Everyone else went for a gimmick (“Ooh, if I do a boot camp, I can eat whatever I want!” “If I only eat protein, I can eat as much as I want!” “If I starve myself for 10 days, then I can eat whatever I want for 5!”).

It’s a human trait to try to find the path of least resistance. It seems to be an American trait, however, to so stubbornly pursue shortcuts. We seem to have been so pampered, we’re on the verge of become imbecilic brats who can no longer understand what it is to take medicine that doesn’t taste exactly like an Orange Julius.

The dressing up of the problem, then, has become big business. Want to get into a good school? It can’t be that the answer is to work hard, be as well-rounded as possible, and let the chips fall where they may; instead, you must game the system in the specific way these handy dandy books’ll tell you. Want to lose weight? Drink this magical elixir (juice) with these magical pills (speed) and watch your appetite disappear (while your blood pressure skyrockets)! Too much trouble to dress yourself? Never fear! Now you don’t have to even go through the trouble of putting on a velour track suit; now there are Pajama Jeans!

I’m not going on another anti-consumerist rampage here. My problem is actually the lack of understanding we as a country show that sometimes medicine is medicine. And that’s not always that bad. There are ways to make it palatable without losing what it is in the first place.

To wit: a French friend of mine was talking to me about the huge business that is recipes for children’s food here. She said she’d been over to a friend’s house and said (very well-meaning) friend was showing her a trick to get her kid to eat carrots: just roast them with honey on top. My friend was perplexed and asked the best question ever: “Why not a nice ratatouille?”

What an excellent question, and an excellent response to all this craziness. Instead of going overboard on gimmicks and tricks and trying so hard to never ever have to realize that something might be unpleasant, why not use a simple method to make it palatable? Want to look better when you roll out of bed? Get nicer pajamas. Better yet, stop caring so much whether or not anyone sees you in pajamas. Want to get better grades? Go to class, take notes, then do the assignments. Want to lose weight? Keep going to the gym, then skip a meal once in a while (or cut back on the ones you already eat). Why not a nice ratatouille indeed?

Seriously, it’s ridiculous that they voted down the public option yesterday, but we all expected it, no? And, in true ridiculous Washington fashion, the vote means nothing really for the ultimate fate of the public option. Much like a government-mandated death panel would likely entail massive bureaucracy, there are still myriad ways to include this thing (let’s call it “Grandma”) in the final bill before we libtards start freaking out for realz.

Mr. Rockefeller has also proposed another amendment, designed to look like the version of a public option included in legislation under consideration in the House. That proposal would base payment rates on Medicare for three years, but would pay a premium of 5 percent above Medicare rates for providers that also accept Medicare. (Not all health care providers accept the government insurance.)

For right now, let’s drop health care and talk education, though. As in, there’s a serious lack of it in the U.S., even in the most unlikely places. Take that woman who refused to deploy to Iraq, since she didn’t want to do so for some Indonesian Muslim-turned-Welfare-thug or whatever: she’s a doctor. Really! Like, if you went into a hospital with a gaping head wound, she might be deployed to fix it, as long as you had your long-form birth certificate.

Anyway, and here’s an elected official speaking:

“There’s a lot to like about a public option,” [Max] Baucus said, but he asserted that the idea could not get the 60 votes needed to overcome a Republican filibuster on the Senate floor.

So, let’s get this straight: Blue Dogs won’t vote for a public option, even though they like it, because it won’t pass because they won’t vote for a public option. Genius!

Now let’s get this guy over to Afghanistan! He can tell the public that we’re there to help democracy by putting a guy who steals elections in power. Everyone* wins!

To continue my rant about what health care reform is vis a vis my experiences here with universal health care, let’s move on to a prescient (and pressing) topic: Drugs. Obama flip-flopped a while ago on drug cost reform, which is the most retarded compromise he’s made yet. Put your Twitter guns away, Sarah. With all due respect to Trig Palin, the most likeable of that whole damned family, I am using “retarded” in the literal sense, meaning that it is slowing progress.

Let me explain. I realized lately that, of all the things that universal health care has meant for me here, maybe the most concrete and loveable is the drug situation. Specifically, I have a baby who just loves to get earaches. Really. Like, 10 a year. As such, I have a house constantly full of two things: Amoxycillin and prescription-strength Ibuprofen (meant for babies with perforated eardrums). In an attempt to curb the constant earaches, our pediatrician recently put her on a daily does of the antibiotics, a course of treatment meant to last for 3 months, which means buying at least 4 bottles of the stuff. Here’s why I say I love this part of universal health care the most:

Finding a way to make that sort of thing unpalatable to the masses would be tough for even the most skilled government-hater. Unless, of course, they bring up that most hated of all words: tax. Time for more math, you say?

My monthly salary, before taxes and social security: about 2200.
My take-home: A little more than 1900.

That’s right. I pay just around 13% for taxes and social security. Included in that is health care, education through college in any EU university for all of my kids, and a nice cushy retirement fund. Oh, and, most pressing for me, is the unemployment benefits, which amount to 70% of your salary for the first 4 months.

Now, granted, Spain is not someplace you move to to get rich. Or someplace you stay to get rich. But, you’d be pretty hard-pressed to find people who are not middle class. And harder-pressed yet to find people who don’t go to the doctor if so much as their nose itches.

Better yet, they can afford the treatment. And who doesn’t love cheap drugs?

A U.S.-funded study involving more than 16,000 volunteers in Thailand found that a combination of ALVAC, made by Paris- based Sanofi-Aventis SA, and AIDSVAX, from VaxGen Inc., of South San Francisco, cut infections by 31.2 percent in the people who received it compared with those on a placebo, scientists said today in Bangkok. Neither vaccine had stopped the virus that causes AIDS when tested separately in previous studies.

In other words, the research into an AIDS vaccine has broken through, and is now showing promise. A lot of promise. Wow.

I may be showing my age a bit by breathing such a huge sigh of relief here. For those who are too young to remember the terror this disease inflicted on the populous, suffice it to say that it was one of the scarier disease threats I’ve ever witnessed. Not just because of its spread, nor its seeming finality, but because of the ugliness it would bring out in social discourse. The wholly erroneous, disgusting, and dangerous notion was that this disease was confined to perverts, who were doomed anyway. The thing that was especially terrifying and repulsive to me was how widespread the notion seemed, and how the idea of catching a disease suddenly seemed like a social stigma unlike any other. In no other fatal medical situation I have witnessed were so many victims blamed, dismissed, brutalized, and discarded.

I hope the possible light at the end of the tunnel in the search for a vaccine can be metaphorical here. Because the way the victims of AIDS are/were treated is not funny, and neither is the way the homosexual community is treated in the United States. Just as the experiment can now move on, after 2 years of stalling, maybe we can also push forward and recognize that civility, tolerance, and empathy are what unites us.

In short: AIDS is not, and never was, a gay issue, but rather a health issue. When it was recognized as such, and when we started taking seriously the steps that could be taken to prevent such an atrocity from happening to anyone, we moved forward, in a direction that is both productive and awesome. Likewise, being granted the right to decide how to live and love is not a gay issue; it’s a Civil Rights issue. Hopefully, when it begins to dawn on us that this is true, we can once again move forward, out of darkness, and into a place that can make us proud.

I hope the possible light at the end of the tunnel in the search for a vaccine can be metaphorical here. Because the way the victims of AIDS are/were treated is not funny, and neither is the way the homosexual community is treated in the United States. Just as the experiment can now move on, after 2 years of stalling, maybe we can also push forward and recognize that civility, tolerance, and empathy are what unites us.

Three things are inspiring me to write this. First of all, I was asked about it. Secondly, health care is kinda sorta in the news nowadays. And thirdly, my upcoming jaunt back to mi patria is bringing back memories…and anger. Why anger, you ask? OK, I’ll start with the last part then…

When I discovered I was pregnant in the States, I was just finishing my degree and didn’t have health insurance or money. I was, however, shocked and delighted to find out that I was eligible for LAMoms, a program of public health care that focused on low-income Louisiana mothers-to-be and their small children. Hurray! And this brings me to my first point.

1. Picking doctors
Under LAMoms, I was allowed to pick my own doctor. Huzzah! And so I did, carefully researching the best OB/Gyns in the area. Turns out, none of them would take my poor ass. Finally, after cold-calling every doctor within a 100-mile radius (no kidding), I found someone who would be willing to take my gubmint insurance. 70 miles away. In three months. Which is a bit late for a first trimester checkup.

Here in Spain, I was not allowed to pick my doctor or my midwife (midwives do the delivering here). I have to say, though, it didn’t bother me for a few reasons. Most notably, I’m not really picky when it comes to doctors, and the very distinct impression given here is that every doctor is equally qualified. Plus, if you really can’t stand a doctor (which happened to me later when visiting a pediatric specialist), you can bitch and moan and change doctors. So, yes, your doctor is determined by your zip code here in Spain, whereas, in the States, my doctor was determined by my insurance coverage. Which reminds me…

2. Public insurance

What exactly is public health insurance? This is a question that should be asked more often, since I think it’s unclear in the States. I say this because I was just researching whether or not our daughter would be covered under the much-ballyhooed CHIP (children’s health insurance) program while we’re visiting. Turns out that, in the state where we’ll be visiting, there does exist a CHIP program to cover all minors. For $147 a month, per kid (capping out at around $400 a month for three or more little buggers). In short, this makes us buying travel insurance for all three of us more cost-effective for the weeks we’ll be there.

That’s not public health insurance, silly!

Spanish public health insurance is a given. It’s a right for all citizens and legal residents, rather than a privilege. And, when I say it’s a given, I mean that: it’s given. Free. Sin pagar. Punto.

As for illegal immigrants, they can go to the doctor too in the ER, for a fee. Just like all us po’ folks in the United States. Oh, and, speaking of ERs…

3. Quality of public health care

This has been a matter of substantial debate, and rightfully so. A lot of people have heard horror stories about huge lines in Canada, and lackluster treatment availability everywhere but the Good Ol’ U S of A, right? While I won’t deny that public health care = waiting, I will describe what I mean. All appointment times for doctor’s visits are what they call “orientative,” and they are granted in blocks. The doctor comes out periodically, tells everyone the order in which they’ll be called, and then the patients police themselves (I still find the Spanish queue system fascinating, but that’s a topic for another day). Given that, I have never spent more than 25 minutes waiting to be seen. Going to the ER, I’ve never spent more than 40, and that was for a routine checkup when I first landed here, was still undocumented, and was not an emergency by any stretch of the imagination (I got a bill for that visit later for 200 euros. However, the health office contacted me, since they had been notified that I was a legal resident, and rescinded that charge, all without me saying anything).

As far as the quality goes, I’ve been pretty impressed, for the most part. My prenatal care was fine, if a bit impersonal (I’ll get to why in a moment), the delivery was expert, and the recovery was brilliant (you stay for three days minimum in a private room). My daughter’s care has been wonderful, and I couldn’t ask for more to be done for her. If I did, it would get done (really, they ask all the time if I’d like to test to verify/negate my various and sundry concerns). Which reminds me…

4. Bureaucracy

This is a bit of a pain here in Spain, in that every single doctor has his/her own specialty. Your GP, OB, pediatrician, and various specialists are all different people (of course), but a lot of times they’ll be in different places around the city. I found it to be the worst with the prenatal care, since my OB was different from my ultrasounder from my blood analyzer, etc…However, I was still undocumented when they assigned me all these people, so I didn’t have a set doctor to refer me. Still, you will never give blood or urine to your doctor in the next room; it will usually be a separate appointment on a different day. Since there’s no such thing as “sick days” here, it doesn’t so much matter to the Spaniards, but it is something that would have to be modified if the U.S. were to adopt a similar system.

Another thing that is always brought up as a terrifying phrase when impending “France-ification” is feared upon us is “strikes.” Yes, the unions in Europe LOVE to strike, and doctors are no different. However, since health care is a right, and not a privilege, the doctors inform their patients of their strikes ahead of time, they only last for one day, there are always subs available, and the ER never ever closes. For example, I know that, if I want to see my daughter’s pediatrician, I can’t go on August 11, since she’ll be on strike. No joke. Which is why…

5. Driving private sector out of business?

Could never happen here in Spain. Native Spaniards, who are accustomed to the luxury of free health care, don’t like the waits or the impersonal nature of the visits. So, they virtually all currently have, or have had, private health insurance. And they can, since it’s quite cheap and doesn’t turn away anyone who may have sneezed once in 1974. So, yes, the private sector is huge here, but it’s inexpensive and inclusive. God forbid that should happen to us.

So, there it is, in a big, fat bloated nutshell. That can go get its arteries unclogged gratis at the local hospital.

Schwarzenneger is in a pickle. Granted. His state is in serious trouble, and has voted not to raise taxes to help alleviate it. And so, confronted with the notion of having a state go bankrupt, he’s making cuts. Got it. And, since federal support is not so much enjoyed by the rich, it’s going to be stuff for the rest of us. Got it.

Salary reductions for state employees are pretty standard, as are, unfortunately, education cuts. They suck, but they’re standard. However…
Mr. Schwarzenegger, a Republican, is threatening to eliminate the Healthy Family Program, the state’s health insurance program that covers over 900,000 children and is financed with state and federal money, as well as the state’s main welfare program, known as Cal-Works, which provides temporary financial assistance to poor families and a caregiver for the severely disabled.

Taking away poor children’s health insurance? Wow. Just…WOW.

Well, at least now we know there’ll never be a Presi-nator, whether or not the Constitutional requirement for nascent citizenship gets amended.

P.S.
Ahnold, watch your back. Hillary’ll get you for this if it’s the last thing she does, especially if Obama’s health care reform goes through and winds up dwarfing her (already small) health care legacy. And, as we all know, that bitch is mean.